Auto-Brewery Syndrome and General Anesthesia: A Case Report

Area of Science:

• Gastroenterology
• Anesthesiology
• Microbiology

Background:

• Auto-brewery syndrome (ABS) is a rare condition characterized by endogenous ethanol fermentation in the gut, leading to intoxication after carbohydrate consumption.
• Patients with ABS present unique challenges for medical procedures requiring anesthesia.
• Previous anesthetic experiences in this ABS patient included postoperative nausea and vomiting (PONV) and intraoperative awareness.

Observation:

• A case study involving a patient diagnosed with Auto-brewery syndrome.
• The patient required general anesthesia for symptomatic wisdom tooth extraction.
• The patient had a history of adverse anesthetic outcomes, including PONV and awareness.

Findings:

• Successful general anesthesia was administered to the ABS patient for dental surgery.
• Anesthetic management was optimized by assessing hepatic function.
• Perioperative carbohydrate intake was strictly avoided.
• Anesthetic depth was increased, and multimodal PONV prophylaxis was employed.
• Broad-spectrum antibiotics were avoided to prevent dysbiosis.

Implications:

• This case demonstrates that ABS patients can undergo general anesthesia safely with appropriate perioperative management.
• Optimized anesthetic protocols for ABS patients can mitigate risks like PONV and awareness.
• The findings underscore the importance of a multidisciplinary approach involving gastroenterologists and anesthesiologists for ABS patient care.
• Further research into anesthetic considerations for rare conditions like ABS is warranted.